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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Analysis of cerebrospinal fluid lactic acid levels in 62 patients suspected of having meningitis was performed. Lactic acid was measured enzymatically using lactic acid dehydrogenase with the liberation of NADH. In a control (no meningitis) group, 46 children had a mean cerebrospinal fluid lactic acid level of 14.7 +/- 2.2 mg/dl; 3 with febrile seizure had a mean lactic acid level of 33.5 +/- 0.98 mg/dl. In 9 cases of bacterial meningitis, the mean lactic acid level was 54.8 +/- 16.8 mg/dl. In 3 patients of aseptic meningitis, the mean lactic acid level was 34.5 +/- 1.0 mg/dl. Serial lactate determination was done in three patients and they were well correlated with the clinical response and other cerebrospinal fluid findings. These data suggest that the determination of cerebrospinal fluid lactic acid may be of diagnostic value in differentiating between bacterial and aseptic meningitis.
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PMID:Diagnostic use of cerebrospinal fluid lactic acid levels in meningitis. 658 98

The purpose of this study was to compare the ability of cerebrospinal fluid (CSF) concentrations of glucose, protein, chloride, lactate, and total amino acids, as well as CSF/blood glucose ratio to distinguish bacterial meningitis from aseptic meningitis. 56 patients with proven bacterial meningitis, 102 patients with aseptic meningitis, and 108 controls were investigated. On admission CSF lactate determination was the most sensitive and the most efficient test to distinguish bacterial meningitis from aseptic meningitis. In patients with bacterial meningitis reexamined after 24-48 h of treatment with antibiotics and compared with patients with aseptic meningitis also reexamined 24-48 h after admission determination of CSF total amino acids was the most sensitive and efficient test.
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PMID:Comparison between cerebrospinal fluid concentrations of glucose, total protein, chloride, lactate, and total amino acids for the differential diagnosis of patients with meningitis. 664 72

In an attempt to develop a rational basis for performing lumbar puncture in sepsis workups, the hypothesis was tested that, for each of eight variables with a known association with bacteremia, the frequencies for patients having bacterial meningitis would be significantly greater than those in patients having bacteremia alone. In a one-year period, 168 lumbar punctures were performed in children having a mean age of 7.3 months. Patients were assigned to four groups: bacterial meningitis, bacteremia only, aseptic meningitis, and normal. Mean age, frequencies of symptoms, clinical appearances, ethnic groups, and sex ratio were determined for all groups. Frequencies of eight variables were determined and compared between Groups I and II.Results indicated that frequencies were not significantly different for groups I and II and that lethargy and petechiae, although distinguishing between groups I and IV, did not distinguish among the three groups having serious disease. It was concluded that since one cannot distinguish among groups having serious disease, all such patients suspected of sepsis should undergo lumbar puncture.
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PMID:Should lumbar puncture be routinely performed in patients with suspected bacteremia? 665 17

The prognosis of tuberculous meningitis is closely linked to the stage at which treatment is started. At the same time the diagnosis will often have to be made on purely circumstantial evidence. Adenosine deaminase activity in the cerebrospinal fluid was evaluated as a diagnostic aid in 30 cases of tuberculous meningitis. Cerebrospinal fluid adenosine deaminase levels differentiated tuberculous meningitis cases from those with aseptic meningitis being higher than 4 U/l in all and higher than 6 U/l in 90% of cases of tuberculous meningitis, but lower than 6 U/l in aseptic meningitis and less than 4 U/l in normal controls. It could not distinguish bacterial meningitis from tuberculous or aseptic meningitis. In cases of low-cell-count bacterial meningitis, the mean cerebrospinal fluid adenosine deaminase level was significantly lower than in cases of tuberculous meningitis with a similar cell count, but considerable overlap of results in the two groups was still to be found.
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PMID:Adenosine deaminase levels in cerebrospinal fluid in the diagnosis of tuberculous meningitis. 671 40

In dogs, the pericardial sac contains about 0.3 ml, and the pleural and peritoneal cavities 0-15 ml of clear, straw-colored fluid of pH 7.4, specific gravity 1.016, protein content less than 3.0 g/dl and cell count less than 3000/microliter. Fat can be cleared from chylous fluid with NaOH and ether. Inflammation is indicated by a cell count greater than 3000/microliter. Amylase levels in peritoneal fluid are elevated in necrotizing pancreatitis. The percentage of polymorphonuclear WBC exceeds 50% in bacterial inflammations. Normal joints contain less than 1 ml highly viscid, clear or straw-colored synovial fluid with less than 1000 nucleated cells/microliter. Synovial fluid becomes flocculent and less viscid in septic and occasionally in immune-mediated arthritis, often with cell counts greater than 75,000/microliter, with 75-90% polymorphonuclear WBC. Cerebrospinal fluid is normally acellular, clear and colorless but may be red, yellow or brown with intracranial hematomas. Viral or aseptic meningitis is characterized by mononuclear cell counts of less than 500/microliter. In acute bacterial meningitis, nucleated cell counts are greater than 1000/microliter, with most being polymorphonuclear WBC. Gram staining of cerebrospinal fluid is not useful.
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PMID:Examination of body fluids. 673 96

The relative frequency of meningitis caused by Haemophilus influenzae in school-age children was determined by reviewing etiologic diagnoses in children 6 to 15 years old admitted to four hospitals from 1974 to 1978. Sixty-five (45%) of 145 patients had aseptic meningitis and 29 (20%) had bacterial meningitis. Thirty-two (22%) of the patients had received antibiotic therapy before diagnosis, and 19 (13%) could not be classified. Six (21%) of the 29 patients with bacterial meningitis had H influenzae meningitis. Although aseptic disease was the most common type of meningitis, initial antibiotic therapy for presumed bacterial meningitis in school-aged children should include adequate coverage for H influenzae.
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PMID:Haemophilus influenzae meningitis in school-aged children. 679 65

The lactate, lysozyme, C-reactive protein and serum amyloid-A protein concentrations in cerebrospinal fluid were measured in 11 patients with bacterial meningitis, 27 patients with aseptic meningitis and in 31 control patients. The mean concentration of each parameter was significantly higher (p less than or equal to 0.0001) in patients with bacterial meningitis than in those with aseptic meningitis or those without meningitis. The reliability of these tests in the differential diagnosis of bacterial and aseptic meningitis was compared with leucocyte counts in cerebrospinal fluid. Gram staining for bacteria, and protein and glucose levels. The cerebrospinal fluid lactate level proved to be more sensitive than lysozyme. C-reactive protein or serum amyloid-A protein and had a high degree of specificity.
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PMID:The differential diagnosis of bacterial and aseptic meningitis using cerebrospinal fluid laboratory tests. 688 72

Total concentrations of amino acids, as measured by fluorometry of primary amino nitrogen with the use of fluorescamine, were determined in the cerebrospinal fluid (CSF) of 50 patients with purulent meningitis, 40 patients with aseptic meningitis, and 36 control subjects. On admission total concentrations of amino acids in the CSF were significantly higher in patients with purulent meningitis (mean +/- SEM, 2.27 +/- 0.27 mM) than in patients with aseptic meningitis (1.07 +/- 0.03 mM, P less than 0.001) or in control subjects (1.16 +/- 0.04 mM, P less than 0.001). This value was higher when the patients with purulent meningitis were reexamined one to two days later and reached a maximum after three to four days of illness. The fluorometry method proved to be simple, rapid, and precise and may be used as an additional test in diagnosing bacterial meningitis, especially in patients who are treated with antibiotics before admission. For patients with bacterial meningitis, a high concentration of amino acids in the CSF on admission may indicate a poor outcome.
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PMID:Increased total concentration of amino acids in the cerebrospinal fluid of patients with purulent meningitis. 706 80

The stability of lactic acid in cerebrospinal fluid specimens from children with or without infections of the central nervous system was determined. Twenty-six patients were studied. These were ten children with bacterial meningitis, nine with aseptic meningitis and seven without any inflammation of the central nervous system. The specimens were left at room temperature and lactic acid concentration was measured at sequential intervals: 15 minutes, and two, six and 24 hours following their collection. A decline in the concentration was noticed in all specimens. However, the most marked total reduction in lactic acid concentration was noted in specimens obtained from patients with bacterial meningitis. The average reduction in that group was 5 mg/dl after two hours, 11 mg/dl after six hours and 18 mg/dl following 24 hours. Lactic acid concentration remained unchanged up to 72 hours in specimens frozen at -20 degrees C. To prevent misleading results, it is recommended that cerebrospinal fluid specimens not be left at room temperature for prolonged periods of time prior to lactic acid determination.
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PMID:Stability of lactic acid in cerebrospinal fluid specimens. 706 19

Cerebrospinal fluid (CSF) lactate was determined in 245 patients by means of a rapid enzymatic method (Monotest Lactate). The mean value was 1.61 mmol/l (range 0.79-3.33) in 104 control patients, 2.06 mmol/l (range 0.76-4.31) in 121 patients with aseptic meningitis, and 8.18 mmol/l (range 1.77-19.21) in 20 patients with bacterial meningitis. In most of the patients CSF protein and the CSF/blood glucose quotient were also determined. Lactate and glucose quotient differentiated equally well between aseptic and bacterial meningitis while protein was somewhat less useful. Suitable values for discrimination between aseptic and bacterial meningitis were judged to be 3.0 mmol/l for CSF lactate, 1.0 g/l for CSF protein and 0.5 for the glucose quotient. Combinations of tests improved the diagnostic accuracy in aseptic but not in bacterial meningitis. In 2 patients with bacterial meningitis all tests failed. CSF lactate may be used as a supplementary aid in the diagnosis of meningitis. Its diagnostic efficacy was equal to but not better than that of the traditional methods.
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PMID:Cerebrospinal fluid lactate in the diagnosis of meningitis. Diagnostic value compared to standard biochemical methods. 710 Aug 21


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